As part of collaborative studies with Honolulu and other Field Research Centers in the WHO schizophrenia research program, we propose to build upon prior work in the WHO Determinants of Outcome Study. We shall study at intake 100-120 consecutively admitted patients who meet criteria for having their first contact for a functional psychosis within the preceding three months. This cohort of patients and their families will be examined and cared for in an integrated clinical research setting by broadly constituted teams of mental health professionals, primarily psychiatrists and psychologists. At initial assessment, we shall carry out a comprehensive assessment of current symptoms and past history, together with measures of disability, social and work functioning, and thought disorder. At the same point in time, key informants will be assessed for prognostic indicators using the Camberwell Family Interview (CFI), a five minute speech sample, and the Rorschach and TAT. We expect to clarify the usefulness of Expressed Emotion as a family prognostic feature, both in our Center and in comparison with other WHO Centers. Alternavites to the CFI, methodologically and conceptually, will also be investigated. Another substudy will examine cross-culturally the KAS-R scales as measures of family perceptions of symptomatology and social behavior. Patients will be followed closely to monitor the timing and quality of remission, with a major focus on the first month after florid psychotic symptoms cease (early remission). We expect to ascertain the usefulness of early remission data as predictors of later course and outcome. Early remission will also be evaluated in relation to features of the florid phase of the index episode, the preflorid phase of the index episode, and premorbid adjustment. AT followup, further standard assessments will be carried out at three months and one year after enrollment in the study, as well as assessments when and if the patient reaches a point of early remission and if he later relapses. Diagnostic comparisons of European ICD-9 and American DSM-III classifications of these controversial acutely psychotic patients will be carried out serially.